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Wednesday, September 26, 2012

Mommy track

I was just thinking the other day about whether there can or should be a mommy track in medical training.

There are other fields where you can have the option of training part time while building a family. Why not in medicine? And this would eliminate resentment aimed at mothers who might need to leave early or call in sick more often due to obligations at home or pregnancy during residency.

I'd imagine residents would take longer to graduate and get paid half salary. If the residency was primarily inpatient, that might be a little trickier to manage, although in outpatient rotations, I'd imagine the resident could just work half days. In a field like PM&R, I could definitely envision how it might work.

24 comments:

While not exactly called "Mommy track", when I was a pre med interviewing at Creighton , I did meet a medical student who was graduating after her third year (hugely pregnant at the time) to start FM residency. I also heard about (but never met) in programs (def not my own) who shared positions with their husbands, each doing a month on, month off, while the other cared for the child. Seemed like a good idea to me.

Being a doctor doesn´t mean having superpowers to me. We still are persons. Our children need us as much as other people´s children - or even more. I totally agree with some kind of parttime to all mothers, no mater the job or work they do. IMO parttime residence or practice should be avaiable for us to choose. ~inês

This is soo timely. Another mommy-Resident and I were talking about this the other day. I would DEFINITELY do my Pediatrics Residency part time, at least until my little one is a little older and we have secured excellent babysitters. Then I'd finish up full time. It could be something like what the Attendings do, 4 days a week with 3 days off.

People have negotiated shared / part time options, although I don't think there are any formal programs a la couples matching.

My University has an option for a part time appointment in the tenure track (approved in 2011), so flexibility is growing.

You might want to look more closely at what attendings do, lest you experience too great a shock when you graduate. Depending on how things are organized, if they are "clinical" for 4 days, I doubt they have the other 3 days "off." There is plenty of non-clinical (academic) work to fill up the rest of their time. Remember, there are no work hours rules for attendings.

Hmmm.... I work more than I did in residency, at least I did until 2 months ago when we got 2 new grads and a guy returned from deployment, I know it'm my fault for selling my soul to the military, but as a working FP there are no 80 hr or nap rules. I can tell you that the 2 new docs were very surprised by how much we work and they are working in this well staffed moment. Perhaps I feel it more having 2 little girls running around and my 3y/o is smart enough to throw some guilt trips my way.

Off track a bit, but I agree with drcolleens above, in terms of my life as a full-time working FP mom vs. life as a resident. There are definite perks to residency because at least there was down time, days off, etc. Not so now. But perhaps it's my fault, too, because I sold my soul to a hospital-run practice?!

As long as it was an option for both mothers and fathers, I'd completely support this. As for your comment about resentment towards mothers, speaking as a single and childless resident, my resentment isn't towards those people who have a legitimate reason for taking leave (sickness, pregnancy, etc.), but rather towards the system that doesn't have any backup built into it. Medicine has to start recognizing that people will need time off for various reasons during their training (mothers and non-mothers alike), and it isn't adequate to expect the already overworked residents and med students to just fill in the void left by a missing team member.

The UCSF Internal Medicine Residency has established this kind of "Flexible Pathway." http://medicine.ucsf.edu/education/residency/program/flexpath.html

I haven't spoken to anyone who is completing it, but they seem to have thought through how to implement it a fair way. It still requires 2-3 months at a time of a full inpatient schedule, so might make finding consistent childcare challenging.

In New Zealand/Australia they offer many of the training schemes part time. you have to do the first year full time, and then as long as you complete the scheme in a certain period of time (normally 8-10 years) you can train at a minimum of a 0.4FTE. You can also take a total of 24 months off for parental leave, and this time does not add towards the years in which you must complete your program. Its one of the main reasons I chose to study medicine in New Zealand (that and I am actually from New Zealand, but a dual American citizen as well). I have talked to many moms in medicine in new zealand who chose these training schemes (family practice, public health, neonatal medicine, pediatrics and more) and they are very happy in the balance between career and family.

In my pathology residency, we had a part time resident, and it worked out fine. However, our program did not "rely" on the residents (because we were few and spread among many institutions - multiple hospitals, the blood bank, the medical examiner, etc) so nobody had to "cover" anyone when they were on leave. If we were there, great. If we weren't, the attending pathologists and other staff took care of everything.

A big reason why there was so much resentment in MY program wasn't because of calls, but because of clinic coverage and the fact that attendings refused to work without a resident. They would have one resident covering three clinics at once before they'd let an attending *gasp* see a patient alone.

There is such a thing as a shared residency option. Although few people do it, I do know a mommy pair who completed one in fm and a married couple who completed one in internal medicine. I have been trying to find a partner to match with (in pediatrics) for over 2 years now. I think the biggest obstacle is finding a partner who wants to go into the same specialty, who is willing to make half the money, and willing to spend twice as many years to complete training. If you refer back to a mim post that was started on September 25 2010, you can read a long discussion about this topic. You can also log onto the NRMP website below http://www.nrmp.org/res_match/special_part/us_seniors/shared_residency.html. If you are interested in matching in peds with a partner please email me at mwiebersj@msn.com

Mothers in Medicine is a group blog by physician-mothers, writing about the unique challenges and joys of tending to two distinct patient populations, both of whom can be quite demanding. We are on call every. single. day.

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